About FLUMIST

For whom is FLUMIST approved for use?

FLUMIST is indicated for patients 2-49 years of age.1

Who should not use FLUMIST and what is the Safety Profile?

FLUMIST is contraindicated in persons who have had a severe allergic reaction (eg, anaphylaxis) to any component of the vaccine including egg protein, or after a previous dose of any influenza vaccine. Do not administer FLUMIST to children or adolescents through 17 years of age who are receiving aspirin or aspirin-containing therapy. Children younger than 5 years of age with recurrent wheezing and persons of any age with asthma may be at increased risk of wheezing following the administration of FLUMIST. If Guillain-Barré syndrome has occurred within 6 weeks of any prior influenza vaccination, the decision to give FLUMIST should be based on careful consideration of the potential benefits and risks.1

How should acute allergic reactions to FLUMIST be managed?

When administered in a healthcare setting, appropriate medical treatment must be immediately available to manage potential anaphylactic reactions following administration of FLUMIST. If FLUMIST is self-administered or
administered by a caregiver, advise the
vaccine recipient that they should seek immediate medical attention if they experience any symptoms of an allergic reaction.

Can patients with asthma get FLUMIST? Are there any risks for wheezing after administration?

Current CDC recommendations state that the live attenuated influenza vaccine should not be used in children 2-4 years of age who have received a diagnosis of asthma or whose parents or caregivers report that a health care provider has told them during the preceding 12 months that the person had wheezing or asthma or whose medical record indicates a wheezing episode has occurred during the preceding 12 months. Current CDC recommendations caution against use in persons ≥ 5 years of age with asthma.2 There is a risk of wheezing following FLUMIST administration, and this risk may be increased in persons of any age with asthma and children younger than 5 years of age with recurrent wheezing.1 The vaccine was not studied in persons with severe asthma or active wheezing.1

Can FLUMIST (LAIV) be administered to people with minor acute illnesses, such as a mild upper respiratory infection (URI) with or without fever?

Yes, unless clinical judgment suggests nasal congestion is present that might keep the vaccine from making good contact with the nasopharyngeal mucosa. In that case, consider either deferring its use until the congestion resolves or using an appropriate alternative influenza vaccine, if available.3

Is FLUMIST suitable for persons with a weakened immune system?

Persons with a weakened immune system or those who care for a severely immunocompromised person who require a protected environment should not receive FLUMIST.1,2 You should use your clinical judgment to determine if FLUMIST is appropriate in such cases. The effectiveness of FLUMIST has not been studied in immunocompromised persons.

Are there any drug interactions with FLUMIST?

Antiviral drugs that are active against influenza A and/or B may reduce the effectiveness of FLUMIST if administered within 48 hours before, or within 2 weeks after, receipt of the vaccine. FLUMIST should not be administered to children and adolescents through 17 years of age who are receiving aspirin therapy or aspirin-containing therapy because of the association of Reye's syndrome with aspirin and wild-type influenza. Avoid aspirin-containing therapy in these age groups during the first 4 weeks after vaccination unless clearly needed.

Dosing and Administration

Do patients need to be revaccinated if they sneeze, cough or have dripping from their nose during FLUMIST administration?

No, patients who sneeze, cough, or have dripping from their nose during FLUMIST administration do not need to be revaccinated.4 It is normal if patients feel a slight tickle or experience some dripping or sneezing. They can wipe away any liquid that drips from the nose with a tissue.1

Is sniffing or inhaling necessary during the administration of FLUMIST?

No, there is no need to inhale or sniff. The patient should breathe normally. It is normal if the patient feels a slight tickle or experiences some dripping or sneezing.1,4 Learn more about administration in this step-by-step guide.

FluMist Home

What is FluMist Home and how is it different from FluMist?

FluMist Home refers to the home delivery service for FLUMIST. The FluMist Home service will ensure eligibility, manage dispensing, delivery and provide pharmacist counseling and support for eligible patients and caregivers who are interested in using FLUMIST at home.

How do patients order FLUMIST via FluMist Home?

FLUMIST, delivered via FluMist Home, is the same flu vaccine (with patient-specific packaging and enhanced administration instructions) currently available in HCP offices and pharmacies that will be shipped direct to patients’ homes. Patients access this option through an online pharmacy where they complete a medical screening questionnaire, provide insurance information, and select a delivery date. A healthcare professional reviews this information to determine eligibility.5 Those who are eligible for FLUMIST will have their doses shipped as requested. Importantly, the pharmacy team can provide support throughout the process. FLUMIST for self-administration and caregiver administration via the FluMist Home service will become available for the 2025-26 flu season.

Can a patient order FLUMIST now and wait to use it at a much later date?

Yes, patients can choose a delivery date that’s convenient for them, and FluMist can be stored in their refrigerator (between 35-46 °F) until they are ready to use it. For example, FLUMIST can be ordered as early as August for use in September or October. FLUMIST should last in a refrigerator until the expiration date, which is printed on the box and also on the sprayer. FLUMIST must not be used after the expiration date on sprayer label.1,5

What is the dosage for FLUMIST at home?

The dosage for FLUMIST is the same, whether a patient administers it at home or gets it at a pharmacy or doctor’s office.1 Each carton of FLUMIST comes with a nasal sprayer that's designed to give the correct amount of FLUMIST per each nostril (1 spray in each nostril, for a total of 2 sprays per dose). Children ages 2-8 who have never received a flu vaccine, should receive their first influenza dose in a traditional healthcare setting.

Other

Does FLUMIST cause flu?

No, FLUMIST is designed to not cause flu.6,7 It contains weakened (attenuated) live viruses that cannot cause flu, like the vaccines for chicken pox and measles.

Can patients catch flu from someone who was just vaccinated with FLUMIST?

While transmission of the vaccine virus is rare, FLUMIST cannot cause the flu.8 The weakened live viruses in the vaccine have been modified and will not cause flu.6,7

Important Safety Information

OPEN

Important Safety Information

  • Do not administer FLUMIST to persons who have had a severe allergic reaction (e.g., anaphylaxis) to any component of the vaccine, including egg protein, or after a previous dose of any influenza vaccine, or to children and adolescents through 17 years of age who are receiving aspirin or aspirin-containing therapy
  • When administered in a healthcare setting, appropriate medical treatment must be immediately available to manage potential anaphylactic reactions. When self-administered or administered by a caregiver, immediate medical attention should be sought if the vaccine recipient experiences symptoms of an allergic reaction
  • In clinical trials, the risks of hospitalization and wheezing were increased in children younger than 2 years of age who received FLUMIST
  • Children younger than 5 years of age with recurrent wheezing and persons of any age with asthma may be at increased risk of wheezing following the administration of FLUMIST. FLUMIST has not been studied in persons with severe asthma or active wheezing
  • If Guillain-Barré syndrome has occurred within 6 weeks of any prior influenza vaccination, the decision to give FLUMIST should be based on careful consideration of potential benefits and risks
  • The effectiveness of FLUMIST has not been studied in immunocompromised persons
  • The safety of FLUMIST in individuals with underlying medical conditions that may predispose them to complications following wild-type influenza infection has not been established
  • FLUMIST may not protect all individuals receiving the vaccine
  • The most common solicited adverse reactions (≥10% in vaccine recipients and at least 5% greater than in placebo) reported after FLUMIST were runny nose or nasal congestion (ages 2-49 years), fever >100 °F (children
    ages 2-6 years), and sore throat (adult ages 18-49 years)

FLUMIST is a vaccine indicated for active immunization of persons 2 through 49 years of age for the prevention of influenza disease caused by influenza virus subtypes A and type B contained in the vaccine. FLUMIST is for intranasal administration only.

Please see full Prescribing Information, including Patient Information and Instructions for Use.

You may report side effects related to AstraZeneca products .

References:
  1. FLUMIST Prescribing Information.
  2. Guidice EL, Campbell JD. Needle-free vaccine delivery. Adv Drug Deliv Rev. 2006;58(1):68-89.
  3. Data on File, REF-263898. AstraZeneca Pharmaceuticals LP.
References:
  1. Grohskopf LA, Ferdinands JM, Blanton LH, Broder KR, Loehr J. Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices—United States, 2024–25 influenza season. MMWR Morb Mortal Wkly Rep. 2024;73(5):1-25. doi:10.15585/mmwr.rr7305a1
  2. Committee on Infectious Diseases. Recommendations for prevention and control of influenza in children, 2024–2025: policy statement. Pediatrics. 2024;154(4):e2024068507. doi:10.1542/peds.2024-068507
  3. Vaccine pricing. Centers for Medicare & Medicaid Services (CMS). Accessed June 10, 2025. https://www.cms.gov/medicare/payment/part-b-drugs/vaccine-pricing
References:
  1. FLUMIST Prescribing Information.
  2. Grohskopf LA, Ferdinands JM, Blanton LH, Broder KR, Loehr J. Prevention and control of seasonal influenza with vaccines: recommendations of the advisory committee on immunization practices—United States, 2024–25 influenza season. MMWR Morb Mortal Wkly Rep. 2024;73(5):1–25. doi:10.15585/mmwr.rr7305a1
  3. Grohskopf LA, Blanton LH, Ferdinands JM, Chung JR, Broder KR, Talbot HK. Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices–United States, 2023-24 influenza season. MMWR Morb Mortal Wkly Rep. 2023;72(No. RR-2):1-25. doi:10.15585/mmwr.rr7305a1rr7202a1
  4. Influenza vaccine products for the 2024-2025 influenza season. Accessed June 10, 2025. https://www.immunize.org/wp-content/uploads/catg.d/p4072.pdf
References:
  1. Giudice EL, Campbell JD. Needle-free vaccine delivery. Adv Drug Deliv Rev. 2006;58(1):68-89. doi:10.1016/j.addr.2005.12.003
  2. FLUMIST Prescribing Information.
  3. Vaccines and immunizations: Vaccine administration. Centers for Disease Control and Prevention. Accessed March 20, 2025. https://www.cdc.gov/vaccines/hcp/imz-best-practices/vaccine-administration.html?CDC_AAref_Val=https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/administration.html#cdc_report_pub_study_section_2-route-of-administration
  4. Murphy BR, Coelingh K. Principles underlying the development and use of live attenuated cold-adapted influenza A and B virus vaccines. Viral Immunol. 2002;15(2):295-323. doi:10.1089/08828240260066242
Reference:
  1. FLUMIST Prescribing Information.
References:
  1. UK Health Security Agency. Surveillance of influenza and other seasonal respiratory viruses in the UK, winter 2022 to 2023. Accessed April 7, 2025. https://www.gov.uk/government/statistics/annual-flu-reports/surveillance-of-influenza-and-other-seasonal-respiratory-viruses-in-the-uk-winter-2022-to-2023
  2. Kissling E, Maurel M, Emborg HD, et al. Interim 2022/23 influenza vaccine effectiveness: six European studies, October 2022 to January 2023. Euro Surveill. 2023;28(21):2300116. doi:10.2807/1560-7917.ES.2023.28.21.2300116
  3. McLean HQ, Petrie JG, Hanson KE, et al. Interim estimates of 2022-23 seasonal influenza vaccine effectiveness–Wisconsin, October 2022–February 2023. MMWR Morb Mortal Wkly Rep. 2023;72(8):201-205. doi:10.15585/mmwr.mm7208a1
  4. UK Health Security Agency. Surveillance of influenza and other seasonal respiratory viruses in the UK, winter 2023 to 2024. Accessed April 25, 2025. https://www.gov.uk/government/statistics/surveillance-of-influenza-and-other-seasonal-respiratory-viruses-in-the-uk-winter-2023-to-2024
  5. Frutos AM, Price AM, Harker E, et al; CDC Influenza Vaccine Effectiveness Collaborators. Interim estimates of 2023-24 seasonal influenza vaccine effectiveness–United States. MMWR Morb Mortal Wkly Rep. 2024;73(8):168-174. doi:10.15585/mmwr.mm7308a3
  6. Grohskopf LA, Blanton LH, Ferdinands JM, Chung JR, Broder KR, Talbot HK. Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices–United States, 2023-24 influenza season. MMWR Morb Mortal Wkly Rep. 2023;72(No. RR-2):1-25. doi:10.15585/mmwr.rr7202a1
  7. Rose AM, Lucaccioni H, Marsh K, et al. Interim 2024/25 influenza vaccine effectiveness: eight European studies, September 2024 to January 2025. Euro Surveill. 2025;30(7):2500102. doi:10.2807/1560-7917.ES.2025.30.7.2500102
  8. Zhu S, Quint J. Interim influenza vaccine effectiveness against laboratory-confirmed influenza, California, October 2024-January 2025. Advisory Committee on Immunization Practices Meeting. Accessed June 17, 2025. https://www.cdc.gov/acip/downloads/slides-2025-04-15-16/03-zhu-influenza-508.pdf
  9. Live attenuated influenza vaccine [LAIV] (the nasal spray flu vaccine). Centers for Disease Control and Prevention. Accessed March 4, 2025. https://www.cdc.gov/flu/vaccine-types/nasalspray.html?CDC_AAref_Val=https://www.cdc.gov/flu/prevent/nasalspray.htm
References:
  1. FLUMIST Prescribing Information.
References:
  1. Newall M, Morris C. Expanding flu vaccine. Ipsos. Accessed April 8, 2025. https://www.ipsos.com/en-us/news-polls/expanding-flu-vaccine
References:
  1. Grohskopf LA, Ferdinands JM, Blanton LH, Broder KR, Loehr J. Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices—United States, 2024-25 influenza season. MMWR Morb Mortal Wkly Rep. 2024;73(5):1-25. doi:10.15585/mmwr.rr7305a1
  2. Committee on Infectious Diseases. Recommendations for prevention and control of influenza in children, 2024–2025: policy statement. Pediatrics. 2024;154(4):e2024068507. doi:10.1542/peds.2024-068507
  3. Healthy People 2030. Increase the proportion of people who get the flu vaccine every year—IID-09. Office of Disease Prevention and Health Promotion, US Dept of Health and Human Services. Accessed April 7, 2025. https://odphp.health.gov/healthypeople/objectives-and-data/about-objectives/healthy-people-2030-objectives-and-measures
References:
  1. FLUMIST Prescribing Information.
  2. Update on influenza B/Yamagata surveillance. Centers for Disease Control and Prevention. Accessed April 7, 2025. https://stacks.cdc.gov/view/cdc/134669
  3. Summary minutes of 183rd Vaccines and Related Biological Products Advisory Committee. Virtual; October 5, 2023: FDA-2023-N-3300. US Food and Drug Administration. Accessed April 7, 2025. https://www.fda.gov/advisory-committees/advisory-committee-calendar/vaccines-and-related-biological-products-advisory-committee-october-5-2023-meeting-announcement?utm_medium=email&utm_source=govdelivery
  4. Types of influenza viruses. Centers for Disease Control and Prevention. Accessed March 19, 2025. https://www.cdc.gov/flu/about/viruses-types.html
  5. Appiah GD, Blanton L, D’Mello T, et al; Centers for Disease Control and Prevention (CDC). Influenza activity—United States, 2014–15 season and composition of the 2015–16 influenza vaccine. MMWR Morb Mortal Wkly Rep. 2015;64(21):583-590.
  6. Davlin SL, Blanton L, Kniss K, et al. Influenza activity—United States, 2015–16 season and composition of the 2016–17 influenza vaccine. MMWR Morb Mortal Wkly Rep. 2016;65(22):567-575. doi:10.15585/mmwr.mm6522a3
  7. Blanton L, Alabi N, Mustaquim D, et al. Update: influenza activity in the United States during the 2016–17 season and composition of the 2017–18 influenza vaccine. MMWR Morb Mortal Wkly Rep. 2017;66(25):668-676. doi:10.15585/mmwr.mm6625a3
  8. Garten R, Blanton L, Elal AIA, et al. Update: influenza activity in the United States during the 2017–18 season and composition of the 2018–19 influenza vaccine. MMWR Morb Mortal Wkly Rep. 2018;67(22):634-642. doi:10.15585/mmwr.mm6722a4
  9. Xu X, Blanton L, Elal AIA, et al. Update: influenza activity in the United States during the 2018–19 season and composition of the 2019–20 influenza vaccine. MMWR Morb Mortal Wkly Rep. 2019;68(24):544-551. doi:10.15585/mmwr.mm6824a3
  10. US virologic surveillance. Centers for Disease Control and Prevention. Accessed April 7, 2025. https://www.cdc.gov/flu/weekly/weeklyarchives2019-2020/Week14.htm
  11. Olsen SJ, Winn AK, Budd AP, et al. Changes in influenza and other respiratory virus activity during the COVID-19 pandemic—United States, 2020–2021. MMWR Morb Mortal Wkly Rep. 2021;70(29):1013-1019. doi:10.15585/mmwr.mm7029a1
  12. FluView summary ending on October 1, 2022. Centers for Disease Control and Prevention. Accessed April 7, 2025. https://www.cdc.gov/flu/weekly/weeklyarchives2021-2022/week39.htm
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References:
  1. FLUMIST Prescribing Information.
  2. Hayden FG, Palese P. Influenza virus. In: Richman DD, Whitley FJ, Hayden FG, eds. Clinical Virology. 4th ed. ASM Press; 2017:1009-1058.
  3. World Health Organization. The Immunological Basis for Immunization Series. Module 23: Influenza Vaccines. World Health Organization, Dept of Immunization, Vaccines and Biologicals; 2017:1-63.
  4. Murphy BR, Coelingh K. Principles underlying the development and use of live attenuated cold-adapted influenza A and B virus vaccines. Viral Immunol. 2002;15(2):295-323. doi:10.1089/08828240260066242
  5. Ambrose CS, Luke C, Coelingh K. Current status of live attenuated influenza vaccine in the United States for seasonal and pandemic influenza. Influenza Other Respir Viruses. 2008;2:193-202. doi:10.1111/j.1750-2659.2008.00056.x
  6. Wodi PA, Morelli V. Chapter 1: Principles of Vaccination. Centers for Disease Control and Prevention. Accessed April 8, 2025. https://www.cdc.gov/pinkbook/hcp/table-of-contents/chapter-1-principles-of-vaccination.html
  7. Vaccine administration. Centers for Disease Control and Prevention. Accessed April 8, 2025. https://www.cdc.gov/vaccines/hcp/imz-best-practices/vaccine-administration.html?CDC_AAref_Val=https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/administration.html
References:
  1. FLUMIST Prescribing Information.
  2. Wodi PA, Morelli V. Chapter 1: Principles of Vaccination. Centers for Disease Control and Prevention. Accessed April 8, 2025. https://www.cdc.gov/pinkbook/hcp/table-of-contents/chapter-1-principles-of-vaccination.html
  3. How flu spreads. Centers for Disease Control and Prevention. Accessed April 8, 2025. www.cdc.gov/flu/about/disease/spread.htm
  4. Different types of flu vaccines. Centers for Disease Control and Prevention. Accessed April 8, 2025. https://www.cdc.gov/flu/vaccine-types/?CDC_AAref_Val=https://www.cdc.gov/flu/prevent/different-flu-vaccines.htm
  5. Block SL, Yi T, Sheldon E, Dubovsky F, Falloon J. A randomized, double-blind noninferiority study of quadrivalent live attenuated influenza vaccine in adults. Vaccine. 2011;29(50):9391-9397. doi:10.1016/j.vaccine.2011.09.109
  6. Block SL, Falloon J, Hirschfield JA, et al. Immunogenicity and safety of a quadrivalent live attenuated influenza vaccine in children. Pediatr Infect Dis J. 2012;31(7):745-751. doi:10.1097/INF.0b013e31825687b0
  7. Hoft DF, Babusis E, Worku S, et al. Live and inactivated influenza vaccines induce similar humoral responses, but only live vaccines induce diverse T-cell responses in young children. J Infect Dis. 2011;204(6):845-853. doi:10.1093/infdis/jir436
  8. Ambrose CS, Wu X, Jones T, Mallory RM. The role of nasal IgA in children vaccinated with live attenuated influenza vaccine. Vaccine. 2012;30(48):6794-6801. doi:10.1016/j.vaccine.2012.09.018
  9. Barría MI, Garrido JL, Stein C, et al. Localized mucosal response to intranasal live attenuated influenza vaccine in adults. J Infect Dis. 2013;207(1):115-124. doi:10.1093/infdis/jis641
  10. Basha S, Hazenfeld S, Brady RC, Subbramanian RA. Comparison of antibody and T-cell responses elicited by licensed inactivated- and live-attenuated influenza vaccines against H3N2 hemagglutinin. Hum Immunol. 2011;72(6):463-469. doi:10.1016/j.humimm.2011.03.001
  11. Belshe RB, Gruber WC, Mendelman PM, et al. Correlates of immune protection induced by live, attenuated, cold-adapted, trivalent, intranasal influenza virus vaccine. J Infect Dis. 2000;181(3):1133-1137. doi:10.1086/315323
References:
  1. FLUMIST Prescribing Information.
  2. Grohskopf LA, Ferdinands JM, Blanton LH, Broder KR, Loehr J. Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices—United States, 2024–25 influenza season. MMWR Morb Mortal Wkly Rep. 2024;73(5):1-25. doi:10.15585/mmwr.rr7305a1
  3. Ask the experts: influenza: live attenuated influenza vaccine (LAIV) issues. Immunize.org. Accessed June 18, 2025. https://www.immunize.org/ask-experts/topic/influenza/laiv-issues/
  4. Vaccines and immunizations: Vaccine administration. Centers for Disease Control and Prevention. Accessed March 20, 2025. https://www.cdc.gov/vaccines/hcp/imz-best-practices/vaccine-administration.html?CDC_AAref_Val=https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/administration.html#cdc_report_pub_study_section_2-route-of-administration
  5. Data on File, REF-263898. AstraZeneca Pharmaceuticals LP.
  6. Key facts about seasonal flu vaccine. Centers for Disease Control and Prevention. Accessed April 8, 2025. https://www.cdc.gov/flu/vaccines/keyfacts.html?CDC_AAref_Val=https://www.cdc.gov/flu/prevent/keyfacts.htm
  7. Live attenuated influenza vaccine [LAIV] (the nasal spray flu vaccine). Centers for Disease Control and Prevention. Accessed April 8, 2025. https://www.cdc.gov/flu/vaccine-types/nasalspray.html?CDC_AAref_Val=https://www.cdc.gov/flu/prevent/nasalspray.htm
  8. Safety of influenza vaccines. Centers for Disease Control and Prevention. Accessed June 10, 2025. https://archive.cdc.gov/#/details?q=safety%20of%20influenza%20vaccines&start=0&rows=10&url=https://www.cdc.gov/flu/professionals/acip/safety-vaccines.htm
References:
  1. Preliminary estimated flu disease burden 2024-2025 flu season. Centers for Disease Control and Prevention. Accessed April 7, 2025. https://archive.cdc.gov/#/details?url=https://www.cdc.gov/flu-burden/php/data-vis/2024-2025.html
  2. Healthy People 2030. Increase the proportion of people who get the flu vaccine every year—IID-09. Office of Disease Prevention and Health Promotion, US Dept of Health and Human Services. Accessed April 7, 2025. https://odphp.health.gov/healthypeople/objectives-and-data/about-objectives/healthy-people-2030-objectives-and-measures
  3. Influenza vaccination coverage, children 6 months through 17 years, United States. Centers for Disease Control and Prevention. Accessed April 7, 2025. https://www.cdc.gov/fluvaxview/dashboard/children-vaccination-coverage.html
  4. Influenza vaccination coverage and intent for vaccination, adults 18 years and older, United States. Centers for Disease Control and Prevention. Accessed April 7, 2025. https://www.cdc.gov/fluvaxview/dashboard/adult-coverage.html
  5. Newall M, Morris C. Expanding flu vaccine. Ipsos. Accessed April 8, 2025. https://www.ipsos.com/en-us/news-polls/expanding-flu-vaccine
  6. Clinical guidance for influenza vaccination. Centers for Disease Control and Prevention. Accessed April 7, 2025. https://www.cdc.gov/flu/hcp/vax-summary/?CDC_AAref_Val=https://www.cdc.gov/flu/professionals/vaccination/vax-summary.htm
Reference:
  1. FLUMIST Prescribing Information.

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